After many years of litigation, the Connecticut District Court granted judgment in favor of a disabled individual against Liberty Life. The claimant had a long-term disability policy through her employer, United Technologies. This was an ERISA plan. She became ill with headaches, fatigue, and was eventually diagnosed with Lyme disease. Different doctors gave her different diagnoses over the years. Her claim for LTD benefits was denied by Liberty, after Liberty claimed that her medical records did not show Lyme disease. Lyme disease is a controversial diagnosis. Some doctors – including those used by many insurance companies – do not believe in chronic Lyme disease at all. The diagnosis of Lyme is a red flag to those insurers.
The court ruled that Liberty’s handling of the claim was arbitrary and capricious. The court was “deeply disturbed by the pervasive errors underlying Liberty’s review of her claim, despite its many opportunities to perform a proper review.” Specifically, the court found that the medical opinions Liberty relied on suffered from numerous and serious flaws. The court ordered Liberty to do another review of the claim, and to comply with all ERISA procedures. Judgment was entered for the claimant.
Liberty reviewed the claim again, and again denied it. Liberty used medical reviewers who specialized in providing opinions for insurance companies. Although Liberty had been ordered to comply with the ERISA procedures, Liberty missed numerous deadlines established in federal regulations. It did not believe that it had to comply with the ERISA regulations on remand.
In a sharply worded and detailed opinion, the court ordered judgment in favor of the claimant and against Liberty.
The case is Spears v. Liberty Life Assurance Company of Boston, 3:11-cv-1807 (VLB)(9/30/19). Zimberlin Law LLC represented the claimant. If you have a long-term disability policy and are thinking about filing a claim, call Zimberlin Law LLC first, at (860) 783-5999. If you have already filed a claim, and have been turned down, call us right away. Remember, there are deadlines to file an appeal of a denial.